Baracos V, Rodemann H P, Dinarello C A, Goldberg A L
N Engl J Med. 1983 Mar 10;308(10):553-8. doi: 10.1056/NEJM198303103081002.
To clarify the mechanisms underlying the loss of body protein during fever and sepsis, we incubated rat muscles with highly purified human leukocytic pyrogen. This polypeptide, which appears identical to interleukin-1, is released by leukocytes and signals the onset of fever in the hypothalamus. In muscles incubated at 37 degrees C, leukocytic pyrogen stimulated net protein degradation by 62 to 118 per cent (P less than 0.001). Proteolysis increased, but rates of muscle-protein synthesis did not change. The pyrogen also dramatically stimulated muscle synthesis of prostaglandin E2, which promotes protein breakdown in this tissue. Addition of indomethacin with leukocytic pyrogen prevented prostaglandin E2 synthesis and abolished the increase in proteolysis. The acceleration of protein breakdown induced by pyrogen was also blocked by Ep-475, an inhibitor of lysosomal thiol proteases. When muscles were incubated at 39 degrees C to mimic fever, protein breakdown increased, but addition of leukocytic pyrogen caused a further marked increase in proteolysis and prostaglandin E2 production. Thus, human leukocytic pyrogen can act on skeletal muscle to stimulate intralysosomal proteolysis by increasing the production of prostaglandin E2. These findings suggest that cyclooxygenase inhibitors may be useful in the treatment of negative nitrogen balance in fever. In addition, the release of prostaglandin E2 induced by leukocytic pyrogen may account for the myalgia that accompanies fever.
为阐明发热和脓毒症期间机体蛋白质丢失的潜在机制,我们用高度纯化的人白细胞致热原孵育大鼠肌肉。这种多肽似乎与白细胞介素 -1 相同,由白细胞释放,可向下丘脑发出发热信号。在 37℃孵育的肌肉中,白细胞致热原使蛋白质净降解增加了 62%至 118%(P<0.001)。蛋白水解增加,但肌肉蛋白合成速率未改变。该致热原还显著刺激了前列腺素 E2 的肌肉合成,而前列腺素 E2 可促进该组织中的蛋白质分解。白细胞致热原与吲哚美辛一起添加可阻止前列腺素 E2 的合成,并消除蛋白水解的增加。致热原诱导的蛋白质分解加速也被溶酶体硫醇蛋白酶抑制剂 Ep - 475 所阻断。当肌肉在 39℃孵育以模拟发热时,蛋白质分解增加,但添加白细胞致热原会导致蛋白水解和前列腺素 E2 产生进一步显著增加。因此,人白细胞致热原可作用于骨骼肌,通过增加前列腺素 E2 的产生来刺激溶酶体内蛋白水解。这些发现表明,环氧化酶抑制剂可能有助于治疗发热时的负氮平衡。此外,白细胞致热原诱导的前列腺素 E2 释放可能是发热伴随肌痛的原因。